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Arthur Caplan Acadia Institute St udy of Bioethics in American So ciety page 1 1 March 2, 1998. Acadia Institute Study of bioethics in American Society. Interview #4 2 with Arthur L. Caplan, Ph.D., Director, Center for Bioethics, Trustee Professor of 3 Bioethics, and Chief, Division of Bioethics, University of Pennsylvania. The interview is 4 being conducted by Dr. Renee C. Fox, and Dr. Carla Messikomer, in Dr. Fox's apartment 5 in Philadelphia. 6 FOX: What was the trajectory of your career at Hastings? You couldn't have gone any 7 further than you went, other than becoming Daniel Callahan himself. So how 8 many years was that all told? 9 CAPLAN: Seven. 10 FOX: Maybe in recounting a little bit your own involvements over those seven years 11 you'll be telling us some things about what was going on at Hastings during that 12 time. 13 CAPLAN: When I say seven, by the way, I am dating that from the time I really was hired as 14 a real staff person. I was there earlier than that as a research assistant, helper, 15 gopher.... 16 FOX: Yes, that's where we left you last time. 17 CAPLAN: I think I told you I was in the second phase of my unethical career. The first one 18 was being a mock medical student. The second was being a post-doc before I was 19 a doc. So I had been there for a year as a post-doc. I'd been there probably in 20 1974 to 1977 as a kind of research assistant type person, very part-time. That's 21 when these things are taking place. Then in 1977-78 I get hired, really put on the 22 faculty. Arthur Caplan Acadia Institute St udy of Bioethics in American So ciety page 2 23 FOX: How did that happen? 24 CAPLAN: Well, it's funny, what really got me hired to was the fact that I seemed to know a 25 lot about genetics. There was a genetics project, an early one at Hastings, had 26 people like John Fletcher, Bob Murray, Marc Lappe, Tabitha Powledge, Alex 27 Capron, on it. I laugh sometimes now when I hear some of the discussion of 28 genetic testing and screening, which acts as if no one ever thought about this. 29 These were early discussions of sickle cell and Tay-Sachs large scale screening 30 and the issues involved, and all the issues were there. Stigmatizing populations, 31 could you get informed consent, did people understand the difference between 32 disease and trait...and on and on. Everything was there. And Hastings ultimately 33 issued a very important document, which I can't remember if I mentioned last 34 time, which was the first ethical guidelines about genetic screening. What was 35 interesting about it wasn't that there were guidelines; it was interesting that it was 36 a Hastings Center group that got into The New En�land Journal and declared 37 guidelines, which was a kind of sociological moment of some interest. It's as if I 38 sat in the room and issued the Art Caplan guidelines, it was like who cares. But 39 clearly Hastings had gotten to the point where a distinguished group would be 40 treated as a serious, blue ribbon panel, or some body of authority and the Journal 41 published their guidelines. That was very interesting for me to watch. I can't say 42 at the time that I was so self-aware of its importance, but I was dimly aware, and it Arthur Caplan Acadia Institute St udy of Bioethics in American So ciety page 3 43 certainly was important looking back on it now. 44 FOX: A very important step in institutionalizing bioethics. 45 CAPLAN: Exactly. It was like Rothman sees Beecher in the 1966 article; the Hastings 46 guidelines was a very important moment in the emergence of non-medically 47 driven bioethics. Here was an interdisciplinary group from a non-medical 48 institution in the leading medical journal publishing on a topic that everybody 49 would have said is something that the geneticists should have done. All that was 50 as interesting; it's as seminal in its way as Beecher's clinical research article 51 because it's saying that all these features are coming together, pay attention to 52 this. Getting baptized almost as a legitimate thing. So that was one of the 53 projects that I helped to staff or do a lot of the scut work. I helped write those 54 guidelines. I would say that Marc Lappe and Tammy Powledge, who were on the 55 staff, did more but I helped them. That was really what got me hired. They knew 56 me pretty well because they had seem me for a couple of years. They had me as a 57 post-doc. I thinkthere was a lot of sentiment. Ruth Macklin would tell you that 58 she wanted to keep me around, and that sort of thing. But it was really the 59 genetics stuff which I seemed to know better, and everybody thought, "Well, 60 genetics is going to have a big future in bioethics." Which it did. Although it's 61 interesting, it dipped. I don't know why it dipped. I have a feeling that there was a 62 little bit of boom and bust, not in the ethics but in the genetics end, that tests were Arthur Caplan Acadia Institute St udy of Bioethics in American So ciety page 4 63 expected to flowafter Tay-Sachs and sickle cell, and didn't. And then it was only 64 the genome mapping project that really got things going in a way that allowed for 65 more disease identification. So I think part of it was that the science stalled, not 66 the ethics. 67 FOX: By and large though, though this is somewhat editorializing, my sense is that 68 bioethicists tended to be more reactive to what developed rather than to go 69 forward and say, "We must continue to work in the genetics area because this is 70 critical." 71 CAPLAN: Some people tried. There were efforts even at that time, in the early '80's, to have 72 a discussion in this genetics group of something hilarious... cloning. We did try. 73 Will Gaylin and I went to every foundation imaginable, one on one. Will knew 74 everybody and we tried to get support for a follow-up project for the genetics 75 group on cloning. And everybody said, "It's science fiction, it's ridiculous, there 76 is no need to do it." So there was no institutional willingness to support 77 something that wasn't real. Plus, to be honest, my impression, was that the 78 scientificcommunity was not willing to tolerate a cloning discussion because it 79 looked too threatening. Remember, subsequent to that there had been a lot of 80 pronouncements about "we will never do germ line engineering," and there were a 81 fair number of pronouncements that we would never do cloning too. But I think 82 these are all defensive, I don't believe any of them for a minute. This idea that Arthur Caplan Acadia Institute St udy of Bioethics in American So ciety page S 83 you wouldn't do germ line genetic engineering, change sperm and eggs, is 84 crazy ... of course you would if you could fix some diseases. You'd absolutely do 85 it. You'd be an idiot not to do it. So what are they talking about? What they 86 mean is we're not going to be eugenecists, we're not going to be Nazis, we're not 87 going to be.... 88 FOX: Where was the recombinant DNA controversy? 89 CAPLAN: That comes in the late 1970's, it's about 1978 to about 1981. And Asilomar must 90 be in there about 1981 , something like that. Did that divert some attention? Yes, 91 and there was one other thing that was going on there too that you'll remember, it 92 was the criminal chromosome fightand the sociobiology and IQ fightingthat was 93 going on at this time. So there were things that were diverting attention away 94 fromthe--let's call it--atoms-for-peace approach to genetics, which was 95 "everything is good and we'll fight diseases, and this will be helpful and will 96 prevent the birth of people with problems." Over to: "Gosh, genetics could be 97 controversial, you might stereotype people." Or maybe it's an attempt to foist 98 eugenic visions on the population, that's what the IQ and the sociobiology debates 99 were about. In fact, a little side note: since we're doing some kind of a history, I 100 was told firmlyby my graduate advisor, ErnstNag el, that I was a fool to spend 101 any time putting together the sociobiology book, which was my first book. Could 102 not take time off from the thesis. I never told him I was doing it, but I did it Arthur Caplan Acadia Institute St udy of Bioethics in American So ciety page 6 103 anyway. It's the biggest selling book I ever wrote! It was like, his intuition is 104 wrong about this! I know, I know, you've got to finish your thesis, I get that. But 105 it was like, this is an opportunity and ifl miss it.. .l know about the biology, I 106 understand the philosophy and this isn't coming back.

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